Determination of bisphenols in beeswax based on sugaring out-assisted liquid-liquid extraction: Method development and application in survey, recycling and degradation studies.

The methodology of sugaring out-assisted liquid-liquid extraction (SULLE) coupled with high-performance liquid chromatography-fluorescence detection was devised for quantifying bisphenol A (BPA) and bisphenol B (BPB) in beeswax. The effectiveness of SULLE was methodically explored and proved superior to the salting out-assisted liquid-liquid extraction approach for beeswax sample preparation. The analytical performance underwent comprehensive validation, revealing detection limits of 10 µg/kg for BPA and 20 µg/kg for BPB. The method developed was employed to analyse commercial beeswax (n = 15), beeswax foundation (n = 15) and wild-build comb wax (n = 26) samples. The analysis revealed BPA presence in four commercial beeswax samples and three beeswax foundation samples, with the highest detected residue content being 88 ± 7 µg/kg. For BPB, two beeswax foundation samples were positive, with concentrations below the limits of quantification and 85 ± 4 µg/kg, respectively. No bisphenols were detected in wild-build comb wax. Furthermore, the bisphenol removal efficacy of two recycling methods-boiling in water and methanol extraction-was assessed. The findings indicated that after four recycling cycles using water boiling, 9.6% of BPA and 29.2% of BPB remained in the beeswax. Whereas methanol extraction resulted in approximately 7% residual after one recycling process. A long-term study over 210 days revealed the slow degradation of bisphenols in comb beeswax. This degradation fitted well with a first-order model, indicating half-lives (DT50) of 139 days for BPA and 151 days for BPB, respectively. This research provides the first report on bisphenol contamination in beeswax. The low removal rate during the recycling process and the gradual degradation in beeswax underscore the significance of bisphenol contamination and migration in bee hives along with their potential risk to pollinators warranting concern. Furthermore, the developed SULLE method shows promise in preparing beeswax samples to analyse other analytes.

[Application of Precision Nursing Based on Multidisciplinary Collaboration Model in Older Patients Undergoing Thoracoscopic Surgery for Lung Cancer].

Objective: To examine the application effect of precision nursing strategies based on multidisciplinary collaboration model in older patients undergoing thoracoscopic surgery for lung cancer. Methods: A total of 100 patients who were admitted to our hospital for thoracoscopic surgery for lung cancer between July 2022 and March 2023 were prospectively enrolled for the study. They were assigned, with a random number table, to two groups, a control group receiving routine nursing care and an experimental group receiving nursing care based on multidisciplinary collaborative precision nursing strategies. Their lung function, anxiety and depression scores, and quality of life were assessed at three points of time, including upon admission, one week after surgery, and one month after surgery, and comparison was made between the two groups. Results: There were significant differences in forced expiratory volume in one second (FEV1) at the three time points ( F=156.787, P<0.001) and the ratio of FEV1 to forced vital capacity (FVC) (FEV1/FVC%) at the three time points ( F=25.587, P<0.001) between two groups. There were significant difference between the findings for FEV1, FEV1/FVC%, FVC, and maximum voluntary ventilation (MVV) indexes at 1 week and those at 1 month after surgery in the experimental group ( P<0.05). After the surgery, the pulmonary function of the experimental group was better than that of the control group. The anxiety and depression scores of the experimental group were lower than those of the control group, with the difference being statistically significant ( P<0.05), which suggested that the experimental group showed improvement in anxiety and depression in comparison with the control group. Regarding the quality of life, there were significant differences between the two groups in the scores for the functional dimension ( F=109.798, P<0.001), the symptom dimension ( F=106.936, P<0.001), other items ( F=78.798, P<0.001), and overall health dimensions ( F=174.307, P<0.001). At 1 week and 1 month after surgery, the experimental group had higher scores for the functional dimension and lower scores for the symptom dimension than the control group did, with the differences being statistically significant ( P<0.05). The overall health status of the experimental group was better than that of the control group. Conclusion: Precision nursing strategies based on multidisciplinary collaboration model can effectively help improve the lung function, the mood, and the quality of life of patients in the short term, showing considerable promise for wide clinical application.

Multi-Model Strategies for Prevention of Infection Caused by Certain Multi-Drug Resistant Organisms in A Rehabilitation Unit: A Semi-Experimental Study.

Objective: To assess the effectiveness of multi-model strategies on healthcare-associated infections (HAIs) caused by multi-drug resistant organisms (MDROs) in rehabilitation units. Methods: A semi-experimental study was conducted in a rehabilitation unit with 181 beds from January 2021 to December 2022 in a teaching hospital with 4300 beds in China. In 2021, many basic prevention and control measures were conducted routinely. Based on the basic measures, strengthening multi-model strategies for the prevention and control of MDROs was pursued year-round since 1 January 2022. Results: A total of 6206 patients were enrolled during the study period. The incidence density of HAIs caused by MDROs decreased from 1.22 (95% CI, 0.96~1.54) cases/1000 patient-days in the pre-intervention period to 0.70 (95% CI, 0.50~0.95) cases/1000 patient-days (p = 0.004). Similarly, the incidence of HAIs in the intervention period was 50.85% lower than that in the pre-intervention period (2.02 (95% CI, 1.50~2.72) vs. 4.11 (95% CI, 3.45-4.85) cases/100 patients, p < 0.001). The rate of MDROs isolated from the environment decreased by 30.00%, although the difference was not statistically significant (p = 0.259). Conclusion: Multi-model strategies can reduce the incidence of HAIs and HAIs caused by certain MDROs in the rehabilitation unit.

A Simple High-Throughput Field Sample Preparation Method Based on Matrix-Induced Sugaring-Out for the Simultaneous Determination of 5-Hydroxymethylfurfural and Phenolic Compounds in Honey.

In the present work, a high-throughput field sample preparation method was reported for the simultaneous determination of 5-hydroxymethylfurfural and phenolic compounds in honey. Combining a simple and green homogenous liquid−liquid extraction, matrix-induced sugaring-out, with the use of a 96-deepwell plate and multichannel pipette, the proposed method showed its merits in instrument-free and high-throughput preparation. Due to the high-throughput property, the parameters of the method were rapidly and systematically studied using a constructed 4 × 2 × 4 × 3 array (sample amount × ratio of ACN:H2O × standing time × replicates) in a 96-deepwell plate. Analytical performance was fully validated, and the limits of detection and limits of quantification were in the range of 0.17−1.35 µg/g and 0.51−4.14 µg/g, respectively. Recoveries were between 83.98 and 117.11%, and all the precisions were <5%. Furthermore, the developed method was successfully applied in the outdoor preparation of commercial honey samples and the in-field preparation of raw honey samples in apiary. The current work presented a simple, rapid, and high-throughput method for the field sample preparation of honey and provides a valuable strategy for the design of field and on-site sample preparation.

Effects of tele-exercise rehabilitation intervention on women at high risk of osteoporotic fractures: study protocol for a randomised controlled trial.

INTRODUCTION: Premenopausal and postmenopausal osteoporosis and associated fragility fractures are major public health problems. Exercise, especially moderate-to-high-intensity impact exercise, has been recommended as an effective, low-cost non-pharmacological strategy for bone strength improvement; however, evidence on fracture risk is limited. In addition, maintaining regular training is currently a problem. Therefore, this study aims to conduct a randomised controlled trial of moderate-to-high-intensity tele-exercise intervention using a tele-rehabilitation app and quantify its effects on vertical fracture and fall prevention in women at high risk of osteoporotic fractures. METHODS AND ANALYSIS: In this multicentre, randomised controlled trial, 794 women at high risk of osteoporotic fractures will be recruited and randomised into either the tele-exercise rehabilitation or control group. Participants in the control group will receive routine remote rehabilitation, while those in the intervention group will be provided with a 6-month tele-exercise rehabilitation. The primary outcomes are the percentage of participants with one or more new vertebral fractures and incidence of falls. Intention-to-treat, full analysis set and per-protocol approaches will be used for outcome analyses. ETHICS AND DISSEMINATION: The study was approved by the biomedical research ethics committee of the West China Hospital of Sichuan University (2021-579). Written informed consent will be obtained from each participant after agreeing to participate in the study. The study findings will be presented at national and international scientific conferences and published in peer-reviewed journals. Results are propagated regardless of the magnitude or direction of the impact. Authorship is assigned according to authorship guidelines as defined by the International Board of Medical Journal Editors, and each author's role is based on journal requirements for publication. TRIAL REGISTRATION NUMBER: The study was registered with the Chinese Clinical Trial Registry (ChiCTR2200058780) prior to recruitment (May 2022).

Dipicolinic Acid-Tb3+/Eu3+ Lanthanide Fluorescence Sensor Array for Rapid and Visual Discrimination of Botanical Origin of Honey.

In the present study, a lanthanide fluorescence sensor array was developed for the discrimination of honey's botanical origin. Dipicolinic acid (DPA) was used as the antenna ligand for sensitizing the fluorescence of Tb3+ and Eu3+ to prepare the DPA-Tb3+/Eu3+ complex. This lanthanide fluorescence sensor showed a cross-reactive response to the major constituents of honey, which led to the result that different classes of honey solution exhibited distinct quenching effects on the fluorescence of the DPA-Tb3+/Eu3+ complex. Furthermore, a fluorescence sensor array composed of ten sensors was constructed by adjusting the pH and the component of the DPA-Tb3+/Eu3+ complex to show multivariate responses towards honey. The visual fluorescence image of the sensor array was recorded by using a smartphone under excitation with portable UV lamp. Results indicated that the pattern of the visual image was related with the botanical origin. After extracting the RGB value of each sensor in 96-well plate, the ratio of R/G was used for principal component analysis (PCA). The results showed that three classes of honey (astragalus, logan, and litchi) were well distinguished. Moreover, the value of principal component 1 (PC1) showed good linearity with the composition of mixing honey and could be used for semi-quantitative analysis. The proposed lanthanide fluorescence sensor array presents a visual and portable method for the discrimination of a honey's origin without the use of analytical instruments, and might provide a novel and simple strategy for the measurement of food origin.

High-throughput subzero-temperature assisted homogenous liquid-liquid extraction for the fast sample preparation of multiple phenolic compounds in propolis.

In the present study, a high-throughput homogenous liquid-liquid extraction method was developed for fast sample preparation of multiple phenolic compounds in propolis. This method was proposed based on cooling samples array in subzero temperature to induce phase separation of ACN-H2O extractant. Due to the high-throughput ability, optimization of extraction parameters was rapidly achieved by using a 5 × 4 × 3 samples array. In addition, multiple arrays were investigated for evaluating the analytical performance of the high-throughput method, which indicated that limits of detection and quantification were ranged from 0.04 to 0.35 µg/mL and 0.12 to 1.05 µg/mL, respectively. Recoveries and precisions in inter-day high-throughput studies were in the range of 90.55-105.50% and 2.58-4.30%, respectively. Comparing with the conventional liquid extraction method, this ecofriendly high-throughput method presented remarkable advantages in reducing sample and chemical consumption, as well as saving labor and time cost. The proposed method might provide a valuable strategy for the design of high-throughput extraction procedures.

Exoskeleton-assisted walking improves pulmonary function and walking parameters among individuals with spinal cord injury: a randomized controlled pilot study.

BACKGROUND: Exoskeleton-assisted walking (EAW) is expected to improve the gait of spinal cord injury (SCI) individuals. However, few studies reported the changes of pulmonary function (PF) parameters after EAW trainings. Hence, we aimed to explore the effect of EAW on PF parameters, 6-min walk test (6MWT) and lower extremity motor score (LEMS) in individuals with SCI and to compare those with conventional trainings. METHODS: In this prospective, single-center, single-blinded randomized controlled pilot study, 18 SCI participants were randomized into the EAW group (n = 9) and conventional group (n = 9) and received 16 sessions of 50-60 min training (4 days/week, 4 weeks). Pulmonary function parameters consisting of the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), forced expiratory flow (FEF), peak expiratory flow, and maximal voluntary ventilation, 6MWT with assisted devices and LEMS were reported pre- and post-training. RESULTS: Values of FVC (p = 0.041), predicted FVC% (p = 0.012) and FEV1 (p = 0.013) were significantly greater in EAW group (FVC: 3.8 ± 1.1 L; FVC% pred = 94.1 ± 24.5%; FEV1: 3.5 ± 1.0 L) compared with conventional group (FVC: 2.8 ± 0.8 L; FVC% pred = 65.4 ± 17.6%; FEV1: 2.4 ± 0.6 L) after training. Participants in EAW group completed 6MWT with median 17.3 m while wearing the exoskeleton. There was no difference in LEMS and no adverse event. CONCLUSIONS: The current results suggest that EAW has potential benefits to facilitate PF parameters among individuals with lower thoracic neurological level of SCI compared with conventional trainings. Additionally, robotic exoskeleton helped walking. TRIAL REGISTRATION: Registered on 22 May 2020 at Chinese Clinical Trial Registry (ChiCTR2000033166). http://www.chictr.org.cn/edit.aspx?pid=53920&htm=4 .

Exercise and education for community-dwelling older participants with knee osteoarthritis: a video-linked programme protocol based on a randomised controlled trial.

BACKGROUND: Neuromuscular and quadriceps exercises have been shown to be effective approaches to relieve pain and to improve function for patients with knee osteoarthritis. In this study, we aim to provide an informative feasible model in which therapeutic exercise and education will be undertaken with physiotherapy supervision and instruction via video link. We also aim to explore the relationship between program-induced pain alleviation/functional improvements and reduction in irritability, which might be mediated through program-induced psychosocial benefits. METHODS: In this proposed two-parallel group (neuromuscular exercise versus quadriceps exercise), single-blinded, randomised controlled trial, participants aged ≥50 years with osteoarthritic knee pain will undergo a 12-week intervention, comprising video-linked education, supervised exercises, and a 12-week follow-up. Seven measurements will be taken to collect longitudinal data. A generalised estimating equation will be used to establish the adjusted difference in effectiveness on pain, function, irritability, and psychosocial outcomes between participants undertaking neuromuscular exercises and those undertaking quadriceps exercises. The primary outcomes are overall average pain in the knee joint during walking, as assessed through the 11-point Numerical Pain Rating Scale, and the Western Ontario and McMaster Universities osteoarthritis index physical function subscale. Furthermore, pressure pain threshold and changes in self-report pain scores pre-, during, and post-exercise were also measured as an indication of irritability. In addition, both the 6-min walk test and a timed up & go test were used to assess walking function performance. Finally, patients' emotions (e.g., fear and catastrophising), self-trust, needs in terms of disease knowledge, mental resilience, social support and health-related quality of life were investigated. Two four-wave cross-lagged models will be used to investigate directional relationships, aiming to investigate the complex mechanisms concerning the effects of exercise programmes. DISCUSSION: Through summarising the study's strengths and limitations, this study may provide promising insights in terms of exercise therapy optimisation for people with knee osteoarthritis and/or other chronic pain within a psychosocial framework. TRIAL REGISTRATION: ChiCTR2100041978 (chictr.org.cn), January 10, 2021.

Micro Salting-Out Assisted Matrix Solid-Phase Dispersion: A Simple and Fast Sample Preparation Method for the Analysis of Bisphenol Contaminants in Bee Pollen.

In the present work, a novel sample preparation method, micro salting-out assisted matrix solid-phase dispersion (µ-SOA-MSPD), was developed for the determination of bisphenol A (BPA) and bisphenol B (BPB) contaminants in bee pollen. The proposed method was designed to combine two classical sample preparation methodologies, matrix solid-phase dispersion (MSPD) and homogenous liquid-liquid extraction (HLLE), to simplify and speed-up the preparation process. Parameters of µ-SOA-MSPD were systematically investigated, and results indicated the significant effect of salt and ACN-H2O extractant on the signal response of analytes. In addition, excellent clean-up ability in removing matrix components was observed when primary secondary amine (PSA) sorbent was introduced into the blending operation. The developed method was fully validated, and the limits of detection for BPA and BPB were 20 µg/kg and 30 µg/kg, respectively. Average recoveries and precisions were ranged from 83.03% to 94.64% and 1.76% to 5.45%, respectively. This is the first report on the analysis of bisphenol contaminants in bee pollen sample, and also on the combination of MSPD and HLLE. The present method might provide a new strategy for simple and fast sample preparation of solid and semi-solid samples.

Rural-urban disparities in knowledge, behaviors, and mental health during COVID-19 pandemic: A community-based cross-sectional survey.

ABSTRACT: To examine the knowledge level, behaviors, and psychological status of the Chinese population during the COVID-19 pandemic, and to explore the differences between urban and rural areas.We carried out a cross-sectional survey of the knowledge, behaviors related to COVID-19, and mental health in a probability sample of 3001 community residents in 30 provinces or districts across China from February 16-23, 2020. Convenience sampling and a snowball sampling were adopted. We used General Anxiety Disorder (GAD), the 9-item Patient Health Questionnaire (PHQ-9), and knowledge and behaviors questionnaire of community residents regarding COVID-19 designed by us to investigate the psychological status, disease-related knowledge, and the behavior of Chinese urban and rural residents during the pandemic.The average score of anxiety and depression among urban residents was 9.15 and 11.25, respectively, while the figures in rural areas were 8.69 and 10.57, respectively. There was a statistically significant difference in the levels of anxiety (P < .01) and depression (P < .01). Urban participants reported significantly higher levels of knowledge regarding COVID-19 in all aspects (transmission, prevention measures, symptoms of infection, treatment, and prognosis) (P < .01), compared to their rural counterparts. While a majority of respondents in urban areas obtained knowledge through WeChat, other apps, and the Internet (P < .01), residents in rural areas accessed information through interactions with the community (P < .01). Urban residents fared well in exchanging knowledge about COVID-19 and advising others to take preventive measures (P < .01), but fared poorly in advising people to visit a hospital if they displayed symptoms of the disease, compared to rural residents (P < .01). Regression analysis with behavior showed that being female (OR = 2.106, 95%CI = 1.259-3.522), aged 18 ≤ age < 65 (OR = 4.059, 95%CI = 2.166-7.607), being satisfied with the precautions taken by the community (OR = 2.594, 95%CI = 1.485-4.530), disinfecting public facilities in the community (OR = 2.342, 95%CI = 1.206-4.547), having knowledge of transmission modes (OR = 3.987, 95%CI: 2.039, 7.798), symptoms (OR = 2.045, 95%CI = 1.054-4.003), and outcomes (OR = 2.740, 95%CI = 1.513-4.962) of COVID-19, and not having anxiety symptoms (OR = 2.578, 95%CI = 1.127-5.901) were positively associated with affirmative behavior in urban areas. Being married (OR = 4.960, 95%CI = 2.608-9.434), being satisfied with the precautions taken by the community (OR = 2.484, 95%CI = 1.315-4.691), screening to ensure face mask wearing before entering the community (OR = 8.809, 95%CI = 2.649-19.294), and having knowledge about precautions (OR = 4.886, 95%CI = 2.604-9.167) and outcomes (OR = 2.657, 95%CI = 1.309-5.391) were positively associated with acceptable conduct in rural areas.The status of anxiety and depression among urban residents was more severe compared to those living in rural areas. There was a difference in being positively associated with constructive behaviors between rural and urban areas.

Subcellular localization of HMGB1 in human cholangiocarcinoma: correlation with tumor stage.

Cholangiocarcinoma (CCA) is a malignant disease with a poor prognosis, and several studies have been conducted using different molecular markers as a tool for CCA diagnosis, including Clonorchis sinensis (CS)-CCA. We initially identified the expression profiles of the three markers of interest, HMGB1, SOX9, and YAP1, using GSE (GSE76297 and GSE32958) datasets. Upregulated levels of these three proteins were detected in CCA samples compared to those in normal samples. To clarify this issue, 24 human CCA tissues with paired adjacent normal tissues were evaluated using immunohistochemical staining. Of the three markers, the total cellular staining intensities were scanned, and subcellular localization was scored in the nuclear and cytoplasmic regions. The intensities of HMGB1, SOX9, and YAP1 were elevated in CCA tissues than the adjacent normal tissues. Individual scoring of subcellular localization revealed that the expression levels of HMGB1 (nucleus) and YAP1 (nucleus and cytoplasm) were significantly different from the pathologic M stage. Moreover, the translocation pattern was categorized using "site-index", and the results demonstrated that the overexpression of HMGB1 and SOX9 was mostly observed in both the nucleus and cytoplasm, whereas YAP1 was predominantly expressed in the cytoplasm of tumor cells. Interestingly, the site index of HMGB1 was moderately correlated with the tumor stage (r = 0.441, p = 0.031). These findings imply that the overexpression of subcellular HMGB1 could be associated with the metastatic status of patients with CS-CCA, which was shown to be effective for CS-CCA prognosis.

Reconfigure rehabilitation services during the Covid-19 pandemic: best practices from Southwest China.

PURPOSE: The healthcare system and service capacity are overwhelmed by the Covid-19 pandemic. There is a substantial unmet need for rehabilitation service to all patients affected by Covid-19 directly or indirectly. This article aims to describe how to rapidly reconfigure and bring rehabilitation services back during the pandemic. METHOD: The Steer committee meeting was held for the development of a strategic preparedness plan and safety management based on principles and evidence of rehabilitation, which will lead to effective mitigation of consequences resulted from Covid-19. RESULTS: Five measures were taken in Southwest China during the pandemic, which includes the "First contact responsibility" and management system; the full-coverage system for nosocomial infection control; the "Closed-off management" system; the full-coverage system for body temperature monitoring; the adoption of 5G-based telerehabilitation. With the implementation of these measures, the capacity and capability were enhanced to safely reopen and operate rehabilitation facilities in Southwest China. CONCLUSION: Further measurement of quality of care and outcomes during and beyond the pandemic is needed in transforming the healthcare system and improving rehabilitation services. Hopefully, the positive message conveyed by this paper could encourage and support communities and the society of physical medicine and rehabilitation worldwide during this challenging time. IMPLICATIONS FOR REHABILITATION Rehabilitation services are essential and there is an unmet need posed by the Covid-19 pandemic. A feasible strategic plan and safety management measures are critical to reconfigure the capacity and capability of rehabilitation services suspended by Covid-19. The adoption of tele-rehabilitation technology has the potential to reshape public health emergency responses and the delivery of care. Measurement of quality and outcomes is of great importance to inform transformation and adaptation of rehabilitation services during and after the Covid-19 pandemic.

Prevalence and risk factors of disability and anxiety in a retrospective cohort of 432 survivors of Coronavirus Disease-2019 (Covid-19) from China.

OBJECTIVE: To estimate the prevalence of disability and anxiety in Covid-19 survivors at discharge from hospital and analyze relative risk by exposures. DESIGN: Multi-center retrospective cohort study. SETTING: Twenty-eight hospitals located in eight provinces of China. METHODS: A total of 432 survivors with laboratory-confirmed SARS CoV-2 infection participated in this study. At discharge, we assessed instrumental activities of daily living (IADL) with Lawton's IADL scale, dependence in activities of daily living (ADL) with the Barthel Index, and anxiety with Zung's self-reported anxiety scale. Exposures included comorbidity, smoking, setting (Hubei vs. others), disease severity, symptoms, and length of hospital stay. Other risk factors considered were age, gender, and ethnicity (Han vs. Tibetan). RESULTS: Prevalence of at least one IADL problem was 36.81% (95% CI: 32.39-41.46). ADL dependence was present in 16.44% (95% CI: 13.23-20.23) and 28.70% (95% CI: 24.63-33.15) were screened positive for clinical anxiety. Adjusted risk ratio (RR) of IADL limitations (RR 2.48, 95% CI: 1.80-3.40), ADL dependence (RR 2.07, 95% CI 1.15-3.76), and probable clinical anxiety (RR 2.53, 95% CI 1.69-3.79) were consistently elevated in survivors with severe Covid-19. Age was an additional independent risk factor for IADL limitations and ADL dependence; and setting (Hubei) for IADL limitations and anxiety. Tibetan ethnicity was a protective factor for anxiety but a risk factor for IADL limitations. CONCLUSION: A significant proportion of Covid-19 survivors had disability and anxiety at discharge from hospital. Health systems need to be prepared for an additional burden resulting from rehabilitation needs of Covid-19 survivors.

The residents' mental health status and community's role during the COVID-19 pandemic: a community-based cross-sectional study in China.

BACKGROUND: The related research of coronavirus disease 2019 (COVID-19) pandemic on the mental health of community residents is still lacking. Here we reported the mental health status of Chinese residents as well as the community's prevention and control during the pandemic period of COVID-19 and further explored the influencing factors of mental status. METHODS: In this cross-sectional study, convenience sampling and snowball sampling methods were adopted from February 16 to February 23, 2020, and Chinese community residents were included according to the inclusion and exclusion criteria. Three questionnaires, including General Anxiety Disorder 7 (GAD-7), Patient Health Questionnaire 9 (PHQ-9), and a self-designed "Community prevention and control questionnaire", were used. A multivariate linear regression analysis was conducted to analyze the impact factors of anxiety and depression. RESULTS: A total of 3,001 community residents were included in this study. In total, 85.6% and 83.7% of participants had minimal anxiety and depression, respectively. Among all the community residents, 16.6% of participants proved that the communities they lived in had confirmed cases. 95.3% of participants reported that the residents were screened for mobility and contact history. 97.8% of participants reported the entrance and exit of the community were managed in their communities. There were 97.5% and 99% of participants needed to take body temperature and wear masks in their communities. Ninety-two percent (92%) of communities have their public areas and facilities disinfected daily, and 95.4% of communities have conducted health education about COVID-19. Factors including gender, education level, chronic illness, the frequency of going out, achieving information about COVID-19 by community and newspaper, and confirmed cases in the community, show association with community residents' anxiety and depression. CONCLUSIONS: The vast majority of Chinese residents have little anxiety and depression, and most communities have adopted standardized control measures following the government's regulations and policy, which plays a vital role in the control of COVID-19 and improving residents' anxiety and depression.

Inactivation of 3-hydroxybutyrate dehydrogenase type 2 promotes proliferation and metastasis of nasopharyngeal carcinoma by iron retention.

BACKGROUND: 3-Hydroxybutyrate dehydrogenase type 2 (BDH2) is known to catalyse a rate-limiting step in the biogenesis of the mammalian siderophore and regulate intracellular iron metabolism. Here we aim to explore the expression and possible function of BDH2 in nasopharyngeal carcinoma (NPC). METHODS: The transcription and protein expression of BDH2 in NPC were determined by both real-time RT-PCR and immunohistochemistry staining assays. Cell proliferation, migration and invasion were evaluated by MTT assay, wound-healing assay and Transwell assay, respectively. The profile of genes regulated by restoring BDH2 expression in NPC cells was analysed by cDNA microarray. The level of iron in NPC cells was detected by iron colorimetric assay. RESULTS: The expression of BDH2 was significantly downregulated in NPC. Ectopic expression of BDH2 inhibited NPC cell proliferation and colony formation. Meanwhile, BDH2 suppressed the migration and invasion of NPC cells by reversing the epithelial-mesenchymal transition (EMT). In addition, a higher level of BDH2 decreased the growth and metastasis of NPC cells via reducing intracellular iron level. CONCLUSIONS: Our findings suggest that BDH2 may be a candidate tumour-suppressor gene in NPC. Decreasing intracellular iron could be an effective therapeutic approach for NPC.

Relevant areas of functioning in patients with adolescent idiopathic scoliosis on the International Classification of Functioning, Disability and Health: The patients' perspective.

OBJECTIVE: To investigate relevant aspects of functioning and disability, and environmental factors in people with adolescent idiopathic scoliosis according to patients' self-reports based on the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY). DESIGN: Multicentre, empirical, cross-sectional study. SETTING: Four departments of orthopaedics in 4 hospitals, and 5 departments of rehabilitation medicine in 5 hospitals. METHODS: Semi-structured interviews were conducted with 975 patients with adolescent idiopathic scoliosis from 5 hospitals according to the patients' self-reporting. In addition, patients were divided into 3 groups according to clinical outcome. Participant information included demographic and disease-related characteristics. Three adolescent idiopathic scoliosis groups were then compared with respect to the problems identified. Interviews were transcribed verbatim. Categories identified by qualitative analysis were subsequently mapped to the ICF-CY using established linking rules. In order to enrich these findings, we also translated the Scoliosis Research Society 22 Patient Questionnaire (SRS-22 PQ) into the language of the ICF-CY, based on ICF linking rules. RESULTS: A total of 1278 themes that linked to 54 ICF-CY cate-gories from 18 chapters were identified. Twenty-two (41%) categories were identified as Body Functions, 7 (13%) as Body Structures, 15 (27%) as Activities and Participation, and 10 (19%) as Environmental Factors. Of the 54 categories, 45 (83%) were second-level, 5 (9%) were third-level, and 4 (7%) were fourth-level. Differences between the SRS-22 PQ results and our findings were observed for several ICF-CY categories. CONCLUSION: Patients with AIS reported activity limitations and participation restrictions combined with impaired body structures and functions. Environmental factors may act as a barrier to, or facilitator of, patient functioning in daily life. The ICF-CY provides a valuable framework for representing the complexity and multifaceted impact of AIS, and for comparing and examining the content of the SRS-22 PQ for AIS in children and adolescents. These results will be used to develop ICF Core Sets for AIS in China.

Epigenetic inactivation of follistatin-like 1 mediates tumor immune evasion in nasopharyngeal carcinoma.

Follistatin like-1 (FSTL1) is a secreted glycoprotein involved in a series of physiological and pathological processes. However, its contribution to the development of cancer, especially the pathogenesis of nasopharyngeal carcinoma (NPC), remains to be elucidated. We aimed to investigate the dysregulation of FSTL1 and its possible function in NPC. FSTL1 was frequently downregulated in NPC cell lines and primary tumor biopsies by promoter hypermethylation. Ectopic expression of FSTL1 significantly suppressed the colony formation, proliferation, migration and invasion ability of NPC cells and induced cell apoptosis. Overexpression of FSTL1 decreased the tumorigenicity of NPC cells in vivo. In addition, the proliferation of NPC cells in vitro was inhibited by treatment with soluble recombinant FSTL1 protein. The protein level of FSTL1 was decreased in primary NPC tumors and was associated with downregulated interleukin 1ß (IL-1ß) and tumor necrosis factor α (TNF-α). Furthermore, recombinant human FSTL1 protein induced secretion of IL-1ß and TNF-α in macrophage cultures, therefore FSTL1 might activate macrophages and attenuate the immune evasion of NPC cells. In conclusion, the epigenetic downregulation of FSTL1 may suppress the proliferation and migration of NPC cells, leading to dysfunctional innate responses in surrounding macrophages.

Epigenetic downregulation of the ISG15-conjugating enzyme UbcH8 impairs lipolysis and correlates with poor prognosis in nasopharyngeal carcinoma.

We identified the UBE2L6 gene, encoding the ISG15-conjugating enzyme UbcH8, as one gene significantly downregulated by promoter hypermethylation in nasopharyngeal carcinoma (NPC). Reduced expression of the UbcH8 protein correlated with poor outcome in NPC patients. Restored expression of UBE2L6 suppressed proliferation and colony formation in NPC cells, while inducing apoptosis. Of particular interest, we found that aberrant lipid turnover was controlled by UbcH8 in NPC through ISG15-conjugation of valosin-containing protein (VCP). Tumor tissue and NPC cell lines showed conspicuously strong accumulation of lipid droplets (LDs) compared to control nasopharyngeal epithelium and non-cancerous cell lines. We demonstrated that UbcH8 counteracts degradation of adipocyte triglyceride lipase (ATGL), a key enzyme in lipid catabolism.

SASS6 overexpression is associated with mitotic chromosomal abnormalities and a poor prognosis in patients with colorectal cancer.

Spindle assembly abnormal protein 6 homolog (SASS6) plays an important role in the regulation of centriole duplication. To date, the genetic alteration of SASS6 has not been reported in human cancers. In the present study, we examined whether SASS6 expression is abnormally regulated in colorectal cancers (CRCs). Increased SASS6 mRNA and protein expression levels were observed in 49 (60.5%) of the 81 primary CRCs and 11 (57.9%) of the 19 primary CRCs, respectively. Moreover, the upregulation of SASS6 mRNA expression was statistically significant (P=0.0410). Next, using DLD-1 colon cancer cells inducibly expressing SASS6, SASS6 overexpression was shown to induce centrosome amplification, mitotic abnormalities such as chromosomal misalignment and lagging chromosome, and chromosomal numerical changes. Furthermore, SASS6 overexpression was associated with anaphase bridge formation, a type of mitotic structural abnormality, in primary CRCs (P<0.01). SASS6 upregulation in colon cancer was also revealed in the Cancer Genome Atlas (TCGA) data and was shown to be an independent predictor of poor survival (multivariate analysis: hazard ratio, 2.805; 95% confidence interval, 1.244­7.512; P=0.0112). Finally, further analysis of the TCGA data demonstrated SASS6 upregulation in a modest manner in 8 of 11 cancer types other than colon cancer, and SASS6 upregulation was found to be associated with a poor survival outcome in patients with kidney renal cell carcinoma and lung adenocarcinoma. Our present findings revealed that the upregulation of SASS6 expression is involved in the pathogenesis of CRC and is associated with a poor prognosis among patients with colon cancer. They also suggest that SASS6 upregulation is a genetic abnormality relatively common in human cancer.